Patients With COPD Face High Risk of Adverse Drug Reactions Due to Multimorbidity

Multimorbidity is common in patients with chronic obstructive pulmonary disease (COPD), and is associated with high levels of polypharmacy, which can lead to an increased risk of adverse drug reactions. According to a new study published in BMJ Open, patients with COPD are likely to be prescribed 3 or more drugs with similar potential side effects.

The paper assessed multimorbidity, polypharmacy, and risk of adverse drug reactions in patients in the UK Biobank, a large, population cohort that recruited 502,640 voluntary participants between the ages of 37 and 73 years from 2006 to 2010.

Multimorbidity was common among participants in the UK Biobank with COPD (85%), and 52% reported taking 5 or more medications. Many of the medications that contributed to the risks of adverse reactions were being used to treat other chronic illnesses, not COPD. The 6 potential adverse drug reactions that the authors identified were falls/fractures, constipation, urinary retention, central nervous system (CNS) depression, bleeding and renal injury.

“Our work shows that co-prescription of drugs with the potential for various adverse drug reactions is common,” lead author Peter Hanlon, MBChB, BMedSci, of the University of Glasgow, said in a statement.

Patients with COPD and cardiovascular disease had the highest percentage of taking 3 or more medications with a risk of falls or renal injuries, while patients with COPD and mental health conditions had the highest percentage of taking 3 or more medications with a risk of constipation, central nervous system depression, or bleeding.

“Our findings are important because it highlights the need for future research to examine the effects of this on healthcare outcomes,” said co-author Frances Mair, MBChB, of the University of Glasgow. “Going forward clinical guidelines need to start emphasizing the importance of the assessment of multimorbidity and adverse drug reaction risk.”

References

Hanlon P, Nicholl BI, Jani BD, et al. Examining patterns of multimorbidity, polypharmacy and risk of adverse drug reactions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study. BMJ Open. 2018;8(1):e018404. doi: 10.1136/bmjopen-2017-018404.